Benefits of Exercises in the Aging Population

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The number of falls and subsequent injuries is increasing as the population is aged 65 years and overgrows. Balance issues and falls are very frequent in the elderly, and they significantly contribute to the increased rates of institutionalization. It is approximated that more than 28 percent of the elderly people above 65 years of age experience falls every year. The rate of falls rises tremendously to more than 40 percent for those who are aged 75 years and above (Hicks et al., 2008). The risks of falls have been established to be strong predictors of morbidity in the geriatric population. Balance issues in elderly individuals are attributed to a number of factors. These factors include weaknesses in muscles that render stability, impaired muscle stimulation patterns, loss of proprioception, and loss of the ability to control normal posture. Further, a reduction in physiological reserves due to advanced age also inhibits the potential to respond to rapid disturbance (Hicks et al., 2008).

Although most falls among older adults (90%) do not cause injury or death, research shows that many are medically and personally serious. Older adults who suffer a fall injury become heavy users of medical resources. Fractures are a common result of falls among older adults, and hip fractures produce the greatest morbidity and mortality. “These lead to loss of independence through disability, as well as fear of falling. The reduction in mobility and independence is often serious enough to result in admission to a hospital or a nursing home, or even in premature death” (Chang 2004). It is critical, therefore, to implement an effective prevention or treatment program.

Old adults have reduced capacity in different body systems—such as skeleton and musculature, proprioception, balance, and vision—which have vital roles in maintaining body balance and strength. When for various reasons these systems are compromised, functional capacity will be reduced, increasing the chance of falls. In addition, people who have previously had a fall are at a higher risk of further falls. Among current randomized clinical trials, a multifactorial fall risk assessment and management program is the most effective component of a fall prevention program (Chang 2004). Exercise is an intervention used in the largest number of studies, and it too has had a statistically significant beneficial effect on the preventing risk of falls (Chang 2004).

Therefore this essay will discuss the effect of exercise in preventing falls, specifically as it improves the musculoskeletal condition, proprioception, and balance in the elderly population.

There is a direct relationship between aging and musculoskeletal system deterioration. With time, skeletal muscle losses its strength because we do less heavy physical work so the muscles tend to detrain. In addition to that, there is also loses contractile component of muscle which controls power. Decreased contractility and strength are due to pathophysiological changes in the body specifically in a number of nerves supplying the muscles. Decrease nerve supplies to muscles which contribute to muscle atrophy. Sarcopenia in old age is associated with impaired functional performance, increased physical disability, and increased risk for falls (Evans 1993). Therefore an exercise program specific to elders, involving strengthening and balance-retraining, is a primary fall prevention strategy. A systemic review by Gillespie et al. shows that an individually tailored program of progressive muscle-strengthening, balance-retraining exercises, and walking has significantly reduced falls over a one-year period. With evidence, sarcopenia can be reversed and prevented through physical exercise and training, especially resistance training. Using an exercise program of sufficient frequency, intensity, and duration, it is quite possible to increase muscle strength and endurance at any age furthermore decrease the incidence of falls in the elder population.

Balance and neuromuscular foundations deteriorate with age. Aptitude to keep up balance is a difficult process that is dependent on three major elements of sensory systems, the brain’s ability to process this information; and muscles and joints for coordinating the movements required to maintain balance. Unfortunately, due to lack of activity and wear and tear mechanism, muscles deteriorate and atrophies and joints become lose responsiveness to balance. Some studies have successfully lowered falls and have used balance-retraining, endurance training, and Tai Chi.

Various studies focusing on FICSIT exercises trials have demonstrated that balance effectively reduces the risk of falling compared to other aspects of exercising. In a study by Tinetti et al. on how various intervention measures decrease the propensity for falls, the researchers demonstrated that in a score range between 0 and 12, a shift of one score considerably reduced the risk of falls by 11 percent. This assertion is supported by Lord (2005), who argues that customized exercise intervention, balance, and muscle strengthening are effective interventions for decreasing the risk of falls among the elderly population. In addition, Cummings-Vaughn and Gammack postulated similarly in their review, indicating that focused balance exercises are effective intervention strategies in minimizing the risk of falls. Moreland et al. also share this assertion and suggest that focused balance exercises are important interventions even in a community setting.

Tai Chi has become an important aspect of exercising focused on reducing the risk of falls in the geriatric population since Tai Chi is a multifactorial intervention that helps in strengthening the body by reengineering the mind. This subsequently makes Tai Chi an appropriate intervention measure for a wide range of physical and mental health aspects, such as maintaining bone density, the flexibility of joints, decreasing the risk of cardiovascular conditions, enhancing the body’s immune status, and promoting emotional health. This makes Tai Chi an important intervention in enhancing balance and reducing the risk of falls in the elderly. It has been demonstrated that Tai Chi is very effective in decreasing the risk of falls for the geriatric population in community settings. It enhances balance since it focuses on various physical health aspects that are essential in maintaining upright posture; for example, leg strength, reflexes, and flexibility.

A study of 256 people aged between 70 and 92 who have gone through a one-hour class three times per week for a six-month Tai Chi program has shown Tai Chi to be effective in reducing the frequency of falls and the risk of falling by 55% (Li et al. 2005). This study has also found that Tai Chi reduces fear of falling. Tai Chi, it is claimed, improves flexibility and functional balance, lower-extremity strength, and postural stability. This claim is further supported by a study conducted by Wolf et al., which has found a decreased risk of multiple falls among older adults after 15 weeks of Tai Chi.

Therefore, Tai Chi exercise is an evidence-based intervention that should be highly recommended to the elderly population to diminish the risk of falls. Another benefit of Tai Chi is its adaptability to every age and fitness level. It doesn’t put too much strain on aging bones and joints which is another concern of frailness in many elders.

Exercises are also an effective intervention measure in reducing the risk of developing osteoporosis. Osteoporosis is a strong predictor of falls in the elderly population. Osteoporosis is the thinning of bones that usually occurs in the population as people advance in age. The condition causes bones to become fragile and prone to fracture. Annually, it is estimated that osteoporosis accounts for over 1.2 million bone fractures (Hicks et al., 2008). Osteoporosis is mainly caused by a lack of enough vitamin D, as well as calcium. In addition, the risk of developing the condition is heightened by failure to engage in exercises that involve bearing weight. Exercises have been shown to help in building and maintaining bone mass effectively. According to Chang et al. (2004), regular exercises induce bone-building processes and retention of calcium, muscle strength, coordination, and balance, thereby strengthening bones and reducing the risk of osteoporosis and falls in the elderly.

Arthritis is also another musculoskeletal condition that is a significant cause of morbidity and joint pain in the elderly. Joint mobilization and muscle strengthening exercises are effective physiotherapeutic interventions for patients suffering from arthritis. The benefits of exercises are that they reduce joint pains and stiffness, enhance muscle tone, and increase flexibility and endurance (Barnett et al., 2003).

To conclude, health care providers need risk assessment tools, so that reliably identify and guide intervention by highlighting remediable risk factors for falls and fall-related injuries, to help prevent falling in the elderly population (Scott #). Improving physiological deterioration by strength exercise, and balance exercise will decrease the incidence of disease. The significant impact on the functional capacity of the elder population, and in the way in which health professionals deal with aging clients, is an important factor for healthy aging.

References

Barnett, A., Smith, B., Lord, S., Williams, M., & Baumand, A. (2003). Community-based group exercise improves balance and reduces falls in at-risk older people: a randomized controlled trial. Age Ageing, 32, 407-414.

Chang, J. T., Morton, S. C., Rubenstein, L. Z., Mojica, W. A., Maglione, M., & Suttorp, M. (2004). Interventions for the prevention of falls in older adults: a systematic review and analysis of randomized clinical trials. BMJ, 328, 680-688.

Hicks, G. E., Gaines, J. M., Shardell, M., & Simonsick, E. M. (2008). Associations of back and leg pain with health status and functional capacity of older adults: findings from the retirement community back pain study. Arthritis Rheum, 59(9), 1306-13.

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Benefits of Exercises in the Aging Population

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